ABSTRACT
Evidence shows videolaryngoscopy (VL) creates a safe atmosphere for tracheal intubations by reducing failed intubations and increasing first-pass success [1]. In 2017, University College London Hospital was one of the first hospitals in the UK to roll out VL to all anaesthetic areas to promote patient safety at a time of increased airway complexity cases. We aim to compare staff attitudes about VL at the time of introduction and 3-years later. Methods We sent online surveys to anaesthetists of all grades before and after the introduction of VL. We had over 90 responses to both surveys. Results Our survey results show that anaesthetists are becoming more in favour of VL with > 93% supporting their use. They show 78% gave VL a maximum +5 on the Likert scale;this is an increase from 59% in the initial survey. It indicates that > 88% perceive VL to promote patient safety, improve quality of care, help in training and improve team dynamics of the intubation process. We see overwhelming support for their use in COVID-19 patients with only 1% of survey respondents having negative views. Subjective responses show that clinicians perceived VL to add 'patient and operator safety'. This is due to 'increased distance of operator from the airway';'reducing anticipated infection risk' and 'improving ease of intubation in the hypoxic patient'. They also feel that VL helps 'share a mental model with the team when other aspects of communication are impaired by PPE'. Our surveys demonstrate fewer concerns with VL over the 3-year period. The results show that concerns amongst anaesthetists with regard to training and familiarity had dropped from 33% to 25%. Concerns over the use of single-use equipment had decreased from 81% to 66%, and concerns regarding documentation of VL intubation grades dropped from 59% to 38%;however, there remains a small but noticeable increase in concern over the loss of direct laryngoscopy skills amongst junior anaesthetists from 55% to 64%. Discussion Our surveys demonstrate a department-wide change in attitude that favours the use of VL. Crucially, clinicians feel that VL provides a strong positive patient safety effect and promotes shared decision-making at a time when rare catastrophic events such as unrecognised oesophageal intubation still occur. The pandemic has proven to be a major catalyst for their increased use and familiarity, which is likely to propel the widespread use of VL in the future.
ABSTRACT
There is a growing need for spatial privacy considerations in the many geo-spatial technologies that have been created as solutions for COVID-19-related issues. Although effective geo-spatial technologies have already been rolled out, most have significantly sacrificed privacy for utility. In this paper, we explore spatial k-anonymity, a privacy-preserving method that can address this unnecessary tradeoff by providing the best of both privacy and utility. After evaluating its past implications in geo-spatial use cases, we propose applications of spatial k-anonymity in the data sharing and managing of COVID-19 contact tracing technologies as well as heat maps showing a user's travel history. We then justify our propositions by comparing spatial k-anonymity with several other spatial privacy methods, including differential privacy, geo-indistinguishability, and manual consent based redaction. Our hope is to raise awareness of the ever-growing risks associated with spatial privacy and how they can be solved with Spatial K-anonymity.
ABSTRACT
Lung transplant (LTx) recipients have increased risk of infection with SARS-CoV-2 and have reduced efficacy from COVID-19 vaccination. The Delta variant of SARS-CoV-2 has increased virulence compared to earlier variants. We hypothesized that LTx recipients would have increased susceptibility to Delta variant infection despite vaccination. We performed a retrospective cohort study of 314 LTx recipients followed between 1/1/2020-9/30/2021. Diagnosis of SARS-CoV-2 infection by PCR was recorded;Delta variant comprised >99% of strains from 6/1/2021-9/30/2021. Data regarding COVID-19 vaccination status, symptom development, hospitalization, intubation, and death were collected. Forty-four patients (14%) were diagnosed with COVID-19, 18 (41%) of which were Delta variant. The rate of infection with Delta was 4-fold higher than with earlier strains (Figure, 0.016 vs. 0.004 cases / patient months, p<0.001). Fifteen (83%) patients diagnosed with Delta variant were fully vaccinated at the time of infection (p<0.001). The rate of infection with Delta variant in vaccinated and unvaccinated individuals was similar (0.017/patient months with vaccine, 0.015/patient months without vaccine, p=0.84). The majority (>89%) of patients had respiratory symptoms in both groups. More patients with Delta variant received monoclonal antibody infusions (89% vs. 54%, p=0.021) and fewer patients with Delta variant had resolution of disease (50% vs. 92%, p<0.001). There was a trend towards greater O 2 needs with Delta variant (p=0.07). Hospitalization (38% vs. 23%), intubation (11% vs. 4%), and death (11% vs. 4%) were numerically greater with Delta variant, although not statistically significant. The incidence rate of SARS-CoV-2 infection was significantly greater with Delta variant in LTx recipients, despite high prevalence of full vaccination during the Delta wave. Further study in larger cohorts is needed to determine whether booster vaccines can reduce such infectivity. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)